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PubMed This is a summary of 69 peer-reviewed journal articles Updated
Otolaryngology · Sinonasal Inverted Papilloma

Sinonasal Inverted Papilloma: A Patient Guide

At a Glance

Sinonasal inverted papilloma is a benign but locally aggressive tumor that usually needs surgery through the nose to remove its attachment site and underlying bone. Long-term nasal examinations are important because the tumor can return and is sometimes linked to a type of cancer.

A diagnosis of sinonasal inverted papilloma represents a unique clinical challenge that requires careful attention. While technically classified as a benign tumor, it is described by specialists as locally aggressive because of its tendency to grow into and potentially damage the surrounding bone of the sinuses, eyes, and skull base [1]. Unlike standard polyps that grow outward, this tumor exhibits endophytic growth, meaning it folds inward into the underlying tissue, which makes it harder to remove and more likely to return if not addressed with precision [2].

A common clinical clue for this condition is its tendency to be unilateral, typically causing persistent blockage, discharge, or minor bleeding on only one side of the nose [3]. Because these symptoms so closely mimic chronic sinusitis or allergies, many patients experience a delay in diagnosis until specialized imaging reveals a mass with a characteristic brain-like appearance [4]. It is this “masquerading” quality that makes it essential to distinguish an inverted papilloma from more common, less aggressive growths through a combination of CT scans, MRIs, and expert pathology [5][6].

The modern standard of care for treating an inverted papilloma is an attachment-oriented surgical resection, usually performed endoscopically through the nostrils [7]. Rather than simply removing the visible mass, the surgeon must identify the “root” or attachment site of the tumor and treat the underlying bone—often by drilling or clearing the area—to ensure it is safely removed [8]. This thoroughness is a crucial factor in preventing the tumor from growing back, though complete removal does not absolutely guarantee a tumor won’t return [9].

Beyond the immediate goal of removal, individualized long-term surveillance is an essential aspect of your care journey. This commitment to monitoring, often lasting five years or more, is necessary because of the tumor’s recurrence rate and a small but significant risk—estimated at roughly 5% to 15%—that it may be associated with squamous cell carcinoma [10][11]. This figure largely reflects cancers found synchronously at the time of initial surgery, though a smaller risk of later transformation exists. By maintaining a consistent schedule of endoscopic check-ups, you and your specialized care team can ensure that any changes are caught early, allowing you to move forward with confidence in your long-term health [12].

In this guide

6 chapters

01

Understanding Your Sinonasal Inverted Papilloma Diagnosis

Learn what a sinonasal inverted papilloma diagnosis means, why it can recur, how imaging and pathology confirm it, and what treatment and follow-up involve.

02

Symptoms and Warning Signs: When to Seek Help

Learn about inverted papilloma symptoms, including one-sided blockage, bleeding, and smell loss, and which warning signs need urgent medical evaluation.

03

Scans and Reports: Auditing Your Diagnosis

Learn how CT, MRI, biopsy, and pathology reports help diagnose sinonasal inverted papilloma, reveal its attachment site, and guide complete tumor removal.

04

The Surgical Goal: Rooting Out the Tumor

Learn how sinonasal inverted papilloma surgery treats the tumor’s root, when endoscopic or open approaches are used, and what recovery requires after surgery.

05

Malignant Transformation: Understanding the Risk

Learn how inverted papilloma can be linked to squamous cell carcinoma, including risk factors, pathology findings, complete removal, and five-year follow-up.

06

Life After Surgery: The Importance of Long-term Monitoring

Learn why long-term monitoring matters after inverted papilloma surgery, including nasal endoscopy, recurrence timing, imaging, and symptoms to report.

Common questions in this guide

What is a sinonasal inverted papilloma?
A sinonasal inverted papilloma is a usually benign tumor that grows inward from the lining of the nose or sinuses. Although it is not usually cancerous, it can grow into nearby bone, return after treatment, and sometimes occur with squamous cell carcinoma, a type of cancer.
What symptoms can an inverted papilloma cause?
Common symptoms include ongoing blockage, drainage, or minor bleeding on one side of the nose. Because these symptoms can look like allergies or chronic sinusitis, imaging and tissue testing may be needed to identify the cause.
How is sinonasal inverted papilloma diagnosed?
Diagnosis commonly combines a CT scan or MRI with examination of a tissue sample by an experienced pathologist. Imaging may show a characteristic brain-like pattern, while tissue testing helps distinguish inverted papilloma from ordinary polyps and cancer.
What surgery is used to treat an inverted papilloma?
The usual treatment is endoscopic surgery performed through the nostrils. The surgeon aims to remove the visible tumor, find its attachment site, and treat the underlying bone because removing only the visible portion can increase the chance of recurrence.
Can an inverted papilloma come back after surgery?
Yes, an inverted papilloma can recur even after it appears to have been completely removed. Follow-up nasal examinations, often for five years or longer, help the care team detect a returning tumor or another concerning change early.
How concerned should I be about cancer with an inverted papilloma?
The page describes an estimated 5% to 15% association with squamous cell carcinoma, with much of that risk involving cancer found at the time of the initial surgery. The risk of a later cancerous change is smaller, so expert tissue review and long-term follow-up are important.

Get notified when new evidence is published on inverted papilloma.

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References

References (12)
  1. 1

    Bilateral inverted papilloma: Case report and literature review.

    Rabhi MA, Sbai AA, Benfadil D, et al.

    Radiology case reports 2025; (20(3)):1499-1503 doi:10.1016/j.radcr.2024.11.053.

    PMID: 39811062
  2. 2

    [Inverted papilloma: a study of 13 cases in the Oto-Rhino-Laryngology at the National University Hospital of Fann].

    Ndiaye M, Ndiaye C, Diouf MS, et al.

    The Pan African medical journal 2019; (34()):71 doi:10.11604/pamj.2019.34.71.19888.

    PMID: 31819787
  3. 3

    Imaging of sinonasal inverted papillomas: A literature review.

    Bouatay R, Koubaa J

    La Tunisie medicale 2025; (103(8)):982-987 doi:10.62438/tunismed.v103i8.5970.

    PMID: 41832633
  4. 4

    Clinical and Epidemiological Profile of Patients with Sinonasal Papilloma in a University Hospital.

    Leão SEG, Brasil MQA, Coêlho Neto J, et al.

    International archives of otorhinolaryngology 2026; (30(1)):1-6 doi:10.1055/s-0045-1811638.

    PMID: 41783035
  5. 5

    Radial intralesional linear calcifications and focal hyperostosis: key points for diagnosis, extension and point of origin identification of sinonasal inverted papilloma.

    Granell E, Cardesin A, Pallares D, et al.

    Rhinology 2025; (63(2)):250-252 doi:10.4193/Rhin24.379.

    PMID: 39968850
  6. 6

    Sinonasal Inverted Papilloma Showing a Misleading Finding on Magnetic Resonance Imaging.

    Numano Y, Nomura K, Sugawara M, et al.

    Ear, nose, & throat journal 2025; (104(2)):NP59-NP62 doi:10.1177/01455613221095614.

    PMID: 35485578
  7. 7

    Attachment-oriented endoscopic surgical management for inverted papillomas in the nasal cavity and paranasal sinuses.

    Makihara S, Kariya S, Naito T, et al.

    Auris, nasus, larynx 2019; (46(5)):748-753 doi:10.1016/j.anl.2019.02.007.

    PMID: 30833129
  8. 8

    Surgical risk factors for recurrence of inverted papilloma.

    Healy DY, Chhabra N, Metson R, et al.

    The Laryngoscope 2016; (126(4)):796-801 doi:10.1002/lary.25663.

    PMID: 26372045
  9. 9

    The choice of endoscopic surgical approach and four steps of operation of inverted papilloma of the maxillary sinus.

    Lou Z

    BMC surgery 2023; (23(1)):7 doi:10.1186/s12893-023-01908-9.

    PMID: 36631783
  10. 10

    Malignant Transformation of Sinonasal Papilloma: Assessment of Clinicopathologic Features, p16 and p53 Expression, Transcriptionally Active HPV Status and Underlying Molecular Alterations.

    Amin SE, Sono R, Al-Jumaili ZI, et al.

    Head and neck pathology 2026; (20(1)).

    PMID: 42008207
  11. 11

    Sinonasal inverted papilloma associated with small cell neuroendocrine carcinoma: A case report and literature review of rare malignancies associated with inverted papilloma.

    Nakamura Y, Suzuki M, Ozaki S, et al.

    Auris, nasus, larynx 2019; (46(4)):641-650 doi:10.1016/j.anl.2018.10.009.

    PMID: 30545727
  12. 12

    Sinonasal squamous cell carcinoma: REFCOR guidelines for diagnosis, treatment and follow-up.

    Vérillaud B, Chatelet F, Baglin AC, et al.

    European annals of otorhinolaryngology, head and neck diseases 2026; (143(4)):319-324 doi:10.1016/j.anorl.2026.06.001.

    PMID: 42409684

This page about sinonasal inverted papilloma is for informational purposes only and does not constitute medical advice. Your ear, nose, and throat specialist and pathologist can explain how the diagnosis, surgery, and follow-up plan apply to you.